What was the patient’s serum sodium level before treatment?

What was the patient’s serum sodium level before treatment?

• A. 122 mEq/L
• B. 135 mEq/L
• C. 118 mEq/L
• D. 150 mEq/L

Answer: (A)

Low serum sodium signals hyponatremia, and in critically ill patients this often drives urgent treatment to prevent brain swelling and neurologic deterioration. A level of 122 mEq/L is clearly hyponatremic and in the range where clinicians would typically begin corrective therapy with hypertonic saline, especially if there are neurologic symptoms. The other numbers describe normal or opposite states: 135 is within the normal range, so it wouldn’t prompt hyponatremia-directed treatment, and 150 is hypernatremic, which requires a different management approach. A value like 118 mEq/L is also hyponatremic and would trigger treatment, but the scenario provided indicates 122 as the pre-treatment level. After initiating therapy, the goal is to correct sodium gradually to avoid osmotic demyelination, monitoring closely to prevent overcorrection.

Low serum sodium signals hyponatremia, and in critically ill patients this often drives urgent treatment to prevent brain swelling and neurologic deterioration. A level of 122 mEq/L is clearly hyponatremic and in the range where clinicians would typically begin corrective therapy with hypertonic saline, especially if there are neurologic symptoms. The other numbers describe normal or opposite states: 135 is within the normal range, so it wouldn’t prompt hyponatremia-directed treatment, and 150 is hypernatremic, which requires a different management approach. A value like 118 mEq/L is also hyponatremic and would trigger treatment, but the scenario provided indicates 122 as the pre-treatment level. After initiating therapy, the goal is to correct sodium gradually to avoid osmotic demyelination, monitoring closely to prevent overcorrection.